chapter 33 - myelodysplastic neoplasms

older than 50 years

MDS are most common in which age group?

dyspoeisis

major indication of MDS in peripheral blood & bone marrow

target cells

alert hematologist should recognize all of the ff peripheral blood abnormalities as diagnostic clues in MDS except

• oval macrocytes

• target cells

• agranular neutrophils

• circulating megakaryocytes

1/3

for erythroid precursor to be considered a ring sideroblast, the iron-laden mitochondria must encircle how much of the nucleus?

20%

according to WHO classification of MDS, what percentage of blasts would constitute transformation to an acute leukemia?

vitamin B₁₂ & folate levels

px

• anemia

• oval macrocytes

• hypersegmented neutrophils

which of the ff tests would be most efficient in differential diagnosis of this disorder?

supportive therapy

lenalidomide if disease progresses

60 year old woman

• fatigue & malaise

• CBC work

  • Hgb — 8 g/dL

  • Hct — 25%

  • RBC count — 2.00 × 10¹²/L

  • platelet count — 550 × 10⁹/L

  • WBC count — 3.8 × 10⁹/L

• WBC differential — unremarkable

• bone marrow examination

  • erythroid hypoplasia

  • hypolobulated megakaryocytes

  • granulopoiesis — appears normal

  • ringed sideroblasts — rare

• chromosome analysis — deletion of 5q only

based on classification of this disorder, what therapy would be most appropriate?

neuropathy

least likely to contribute to px with MDS

AML

into what other hematologic disease does MDS often convert

MDS/MPN

chronic myelomonocytic leukemia is classified in the WHO system as?